Physiological Psychology Final Exam Flashcards
Brain Uses…
20% of total resting oxygen
15-20% of total blood flow goes to brain
60% of glucose metabolism.
Energy Divisions…
Approx. 25% - maintaining neurons and glial cells
Approx. 75% - electrical signaling across the brain’s circuit.
Apoptosis
Planned and purposeful neuronal death.
Removal of damaged or unseeded neurons.
Necrosis
Unplanned and uncontrolled neuronal death.
Synaptic Pruning
A natural process that occurs in the brain between early childhood and adulthood.
- Brain eliminates extra synapses.
- Pruning –> Efficiency
Synapses
Brain structures that allow the neurons to transmit an electrical or chemical signal to another neuron.
Schizophrenia is correlated with…
Decrease synapses.
Autism is correlated with…
Increase synapses.
Caveat
Brain is a close circuit and everything works in conjunction.
Frontal Lobe
Executive functions.
- Emotion regulation.
- Planning
- Reasoning
- Inhibitory Control
Dominant Hemisphere-Frontal Lobe
Social conduct.
Prefrontal Cortex
Seat of planning and strategizing.
Ventromedial PFC
Empathy and guilt.
Parietal Lobe
Integrating sensory information, including touch, temperature, pressure and pain.
Temporal Lobe
Processing sensory information, particularly important for hearing, recognizing language, and forming memories.
- Contains the primary auditory cortex.
Occipital Lobe
Visual processing (depth, distance, location).
- Contains the primary visual cortex.
Basal Ganglia
Controls motor control, as well as other roles such as motor learning, executive functions and behaviors, and emotions.
- Part of the limbic system.
Substantia Nigra
Produces dopamine (high concentration in Basal Ganglia).
Dopamine Dysfunction
Movement disorder such as Parkinsonian syndrome, dystonia, chorea, and tics.
Suppress of motor function = ?
Decreased purposeful movement.
Blood supply to area…
- 5L/min blood pumped every minute.
- Entire volume of blood supply circulates every minute.
Intravenous
Fastest and most dangerous.
- 30-60 seconds.
Administration Types:
- Intravenous
- Intraperitoneal
- Intramuscular
- Subcutaneous
- Intracerebral (bypass BBB)
- Oral
- Intrarectal
- Inhalation (lungs) vs. insufflation (nasal)
- Topical
Entry of Drugs in Brain
- Drugs exert effects only in their sites of action.
- Mostly on or in cells of the CNS.
- Most important factor is determining the rate of lipid solubility. Lipid soluble materials pass through the most rapidly.
- Heroin > Morphine
Therapeutic Index
A quantitative measurement of the relative safety of a drug.
- Lower ratio = MORE DANGEROUS
- Ideal TI <10
- ED50 and TD50 provide a ratio for therapeutic index.
Effective Dose
50 (ED50): dose that produces the desired effects in 50% of individuals
Toxic Dose
50 (TD50): dose that produces toxic effects in 50% of individuals.
Agonist
A molecule that by binding to the receptor stimulates a response = increase postsynaptic effects.
- Addictive drugs (heroin, morphine, oxycodone) –> stimulation leads to “high”.
Antagonists
A molecule that by binding to a receptor blocks or inhibits the response = decrease in postsynaptic effects.
- Botulin poison causes paralysis by blocking release of acetylcholine –> wrinkles cannot form d/t the are being paralyzed.
Mesolimbic Dopamine Pathway
Route between VTAA, nucleus accumbens, and limbic system (hippocampus and amygdala).
- Key pathway in pleasure and reward.
- Substance Use.
Mesocortical Dopamine Pathway
Route between VTA/nucleus accumbens and PFC.
Stress
Increase corticotropin-releasing hormone (CRH)
- Strengthens the amygdala.
- Weakens the hippocampus and prefrontal cortex.
Stress results in…
- Negative emotional state.
- Lack of executive control = increase risk of relapse
- Memory of relief/craving.
How many adolescents who report abuse/neglect will develop an SUD before 18?
1/3
COVID19 led to what % increase in AUD?
23% increase.
How much more risk do those with PTSD have in developing chemical dependency?
2-4x
Moderate Drinking Guidelines (CDC)
Females = up to 1 drink per day
Males = up to 2 drinks per day
Heavy Drinking
Females = 8 or more per week
Males - 15 or more per week.
Binge Drinking
Females = 4 or more
Males = 5 or more.
Stimulant Pharmacokinetics
Stimulants impact the brain’s level of epinephrine/norepinephrine (E/NE), dopamine (DA), and serotonin (5-TH).
- Stimulants impact each to a varying degree.
- Cause alertness, attention, and energy.
Several medical uses and rich history (Freud’s Uber Coca)
Pain management, ADHD, asthma, obesity, narcolepsy.
Primary Risk Factors of Stimulants
- Reduced seizure threshold.
- Increase BP, HR, HTN = increase risk of stroke, MI
- Poor appetite, mood swings, anxiety, insomnia
- Toxic levels = paranoia, psychosis.
The Endocannabinoid System
Comprises a vast network of chemical signals and cellular receptor that are densely packed throughout our brains and body. A neuromodulation system.
CB1 Receptor
Increase in brain and lower concentration wide spread.
Mediates most of the psychoactive effects of cannabinoids.
CB2 Receptor
Principally involved in anti-inflammatory and immunosuppression actions.
Phytocannabinoid
Biologically active compound in cannabis.
What are the most notable cannabinoids?
- Delta-9-tetrahydocannabinoic (THC)
- Cannabidiol (CBD)
THC Content
- <.3% in hemp
- > .3% in marijuana
Anandamide
A endocannabinoid (neuromodulator) found in the endocannabinoid system.
- THC mimics anadamine –> effecting the endocannabinoid system.
- TCH much more potent than anandamide
- Effects energy, mood, appetite, and perception of time.
Absorption of Cannabis
Inhalation:
- Peak plasma concentration 3-10 minus
- Bioavailability = 10-35%
Oral:
- Peak plasma concentration ~120 minutes.
- Bioavailability = 6-20%
Distribution of Cannabis
- Rapidly to well-vascularized organs.
- Accumulates in adipose tissues.
Metabolism of Cannabis
- Predominantly hepatic.
- Able to cross the placenta; released in breast milk
- Excreted through urine, feces, and sweat.
Glucose
Primary source of fuel for the brain.
- ~20% of glucose-derived energy.
- Is necessary-provides precursors for NT synthesis and apoptosis.
- Glucose levels correlated with thinking, memory, learning.
High-Sugar Diets
Decrease brain-derived neurotrophic factors (BDNF)
- BDNF modulates growth, development and communication between synapses–decreased levels leads to increased risk of neurodegenerative disorders due to atrophy and small vessels disease.
- Americans consume 156lbs of sugar per year.
- AMA recommends 6-9tsps per day
How long do teens aged 13-18 spend a day on screens?
8.4 hours
What do “likes”, “re-tweets”, “novelty” do?
Increase mesolimbic activation.
Role of COVID19 and screen time
Triggers = boredom, isolation, low self-esteem.
Center of Internet and Technology Addiction
- Digital Distraction Test
- Smartphone Compulsion Test
- Virtual Addiction Test
VMPFC
Interface between emotional responses and control of complex behaviors.
- Using emotional rxns to guide behaviors.
Patient E.R.-Bilateral Damage to the VMPFC
- Excellent social judgement in verbal responses to hypothetical situations, expansive reasoning shared.
- Real life situations: unable to prioritize between trivial and important decisions.
Courage does what to VMPFC activation?
Increases VMPFC activation.
What happens to the VMPFC activation in impulsive/emotional murderers?
Decrease in VMPFC activation vs. calculating/careful = typical brain pattern.
Antisocial PD does what to VMPFC activation?
11% decrease of gray matter in VMPFC.
Photos of romantic partners leads to what?
- Increase caudate nucleus (processes visual information and controls movement).
- Increase ventral tegmental area (mediates reward system) = increase hyperfocus.
What does love to do the body?
- Increase HR, sweating, anxiety, and nervousness.
- Decreased appetite, concentration.
- Dilated eyes.
“Love is Blind”
Decrease PFC activation (d/t “fight or flight”) = reduced social judgement and increase risk taking.
Post-Orgasm
In Women: increase oxytocin = feelings of attachment and bonding.
In Men: increase vasopressin = vigilance and need to guard/protect partner.
How long does each sleep cycle last?
Approx. 90 minutes.
- Alternates between REM and NREM
What is the predominant first half of sleep at night?
SWS
What is the predominant second half of sleep at night?
REM
In the days following daylight savings time, there has been:
- 24% increase in myocardinal infarction.
- 6% increase in traffic accidents
- Increase mood disturbance and suicide.
- Volatility in stock markets.
American Academy of Sleep Medicine believes seasonal time changes should be abolished.
Effects of Sleep Deprivation
Extensive sleep deprivation is fatal in rats.
Fatal Familial Insomnia
Inherited neurological disorder. Is a progressive insomnia. Results in damage to portions of thalamus. Death after 12 months.
- One potential etiology: sleep destroys free radicals and prevents their damaging effects.
Adenosine (Inhibitory)
- Astrocytes store glycogen for “emergency energy”
- Broken into glucose and given to neurons. - Adenosine is by-product (ATP -> Adenosine).
- Neurons are hungry because they are active and have used up all their glucose. - Accumulation of adenosine produces increase delta sleep.
- If we stimulate adenosine receptors (meds) = increase in delta sleep = increase in ATP to replace what was using during day. - Adenosine increases steadily during day producing sleep feeling at night.
- Recycles at night.
- Without sleep = decrease in available ATP, continue increase in adenosine.
- Caffeine blocks adenosine receptors = decrease in sleepiness but increase in fatigue.
Sleep deprivation leads to…
Decrease in glycogen stores and increase in adenosine which leads to sleepiness.
Melatonin
Produced by pineal gland in response to evening/darkness about 2hrs. before normal sleep time.
- Serotonin is converted into melatonin.
Exogenous Melatonin
Take 1-2mgs. 30 minutes to 1 hour before bedtime.
- Light, especially blue light negative melatonin effect.
- Contraindicated in older adults with dementia and those with dementia.
Sleep Apnea
Effects 18 million Americans.
- Difficulties sleeping and breathing at the same time leading to increase CO2 -> stimulates chemoreceptors.
–> Wake up gasping for air and decreased slow wave activity.
Obstructive Sleep Apnea
Due to narrowing of airway (obesity, enlarged tonsils, hormonal changes).
Central Sleep Apnea
Brain does not signal need to breath.
Sleep Apnea Left Untreated
Significant deficit in attention, memory and executive functions.
- Up to 1.5 SD drop
- MCI dx 10 years earlier.
- Increase risk of strong, MI
- In kids; 2.5x risks of behavioral problems.
Treatment for Sleep Apnea
Via CPAP, BiPAP, can reverse cognitive deficits with treatment.
Broca’s Area
Motor
Frontal Lobe
Speech is low and broken.
EXPRESSIVE
Wernicke’s Area
Sensory
Temporal Lobe
Speech is normal and excessive but makes little sense.
RECEPTIVE
Learning
Stage 1: Sensory Information
- Information is first processed through out senses (i.e., echoic memory).
- <1second.
Stage 2: Short Term Memory
- Meaningful/salient information
- <1minute.
- Can support via repetition or chunking.
- (7 +/- 2 Rule)
Stage 3: Long Term Memory
- Short term memories are converted into long term memories via CONSOLIDATION.
- Can be retrieved across a lifetime.
- Increase retrieval (i.e., rehearsal = strengthening of memory)
- Involves the hippocampus.
Observational Learning/Social Learning Theory
Process of learning by watching behavior of models. Occurs via operant conditioning and vicarious conditioning.
Most likely to mimic model who…
- Positive perception
- Shared (perceived) traits
- Stand out
- Familiarity
- Self-efficacy in mimicry
- Social media
- Violence in games and entertainment
MCA Strokes
90% of strokes
- Largest of brain arteries.
- supplies most of the outer surface of the frontal, parietal, temporal lobes and the basal ganglia.
- Includes pre-central (sensory) and post-central (motor) gyrus.
Middle Cerebral Artery (MCA) Stroke Symptoms
- Contralateral weakness and sensory loss in upper extremities.
Homonymous Hemianopia
Loss of visual field
Left MCA Stroke
Speech deficits.
- Broca’s Aphasia
- Wernicke’s Aphasia.
Right MCA Stroke
Neglect and poor motivation.
- Flat prosody.
Anterior Cerebral Artery (ACA) Stroke
Less common.
- (L) ACA > (R) ACA
- Feeds deep structures in the brain, frontal, parietal, corpus callosum and bottom of the cerebrum.
Symptoms of ACA Stroke
- Contralateral motor and sensory loss in lower extremities.
- Poor gait and coordination = clumsy
- Slowed initiation (abulia)
- Flat affect
- Urinary incontinence.
Depression Post Stroke
- Post stroke depression = 1/3 survivors
- 6x increase risk of depression 2-3 years post stroke
- More common in L frontal and basal ganglia strokes
- Adversely effects functional recovery
- Increase risk factor = premorbid depression and social isolation post stroke.
Anxiety Post Stroke
- 1/4 met GAD criteria post stroke.
- Less common.
Psychosis Post Stroke
- More common in right-temporo-parietal-occipito area lesions, seizures, and subcortical atrophy.
- Pseudobulbar Affect = 10-15% post stroke patients.
- Hypomanic Symptoms = 1%
BEFAST
Balance
Eyes
Face
Arms-raise both arms for 10 seconds
Speech
Time
Tissue Plasminogen (tPA)
Can be administered within 4.5 hours
- Helps to restore blood flow to brain regions affected by the stroke, thereby limiting the risk of damage and functional impairment.
- After that time, has hemorrhagic effect.
Deficiency of Vitamin D
- Nearly 40-50% of men and women in Denver metro area are deficient in vitamin D.
- More melanin in your skin, the harder it is to synthesize vitamin D.
- Concurrent with anti-depressant support.
Magnesium Deficiency
- w/ stress can increase agitation, anxiety, sleeplessness, headaches, and apathy.
- Can treat restless leg syndrome.
- Slow response time to reach steady state via oral supplementation (30+ weeks)
Omega-3 Fatty Oils
- Add on treatment for depression (strong evidence)
- For ADHD (some evidence)
Anorexia Heritability Rate
Twin study = 58-76% heritability.
- Increases with premature birth of birth trauma
Anorexia is Associated with…
- Loss of gray and white matter in the brain.
- Enlarged ventricles and widened sulci (shrinkage of brain tissues).
- Inhibited emotional facial expression despite reporting similar or more intense emotions.
- Tissue loss can be reserved with successful treatment of eating disorder.
Starvation Study
6 months ate at 50% of baseline.
- Loss 25% of body weight.
- Demonstrated preoccupation w/food, ritualistic eating, erratic mood, impaired cognition, slowed eating/lingering.
Excessive Exercise
Starved mice run on wheel more–food seeking?
Gender Differences in Fasting
Women ate less post-fast than men.
Treatment of Anorexia
CBT, increasing eating speed, stimulation of ACC?
- Restricted food access = starvation = anorexia?
Alpha Diversity
A measure in microbial ecology of “species” of diversity, specifically, the diversity within a sample.
Beta Diversity
A measure in microbial ecology of species diversity, specifically, the diversity between samples.
Dysbiosis
Disruption of the gut microbial diversity and community structure, typically due to reduction in beneficial bacteria and overgrowth of harmful bacteria yeast and or parasites.
Old Friends
Microbes that evolved alongside the mammalian immune system–thought to have been intricately involved with the human immune defense development.
What is one factor contributing to increase in chronic inflammatory disorder in high income countries?
Failing immunoregulation, attributable to reduced exposure to microbial environment within which the mammalian immune system co-evolved.
“Old Friends” and Psychiatric Disorders
Some psychiatric disorders in developed countries might be attributable to failure of immunoregulatory circuits to terminate ongoing inflammatory responses.
Sex and Age Breakdown of TBI
Males (15-24) more likely to experience TBIs
Events out as age gets older.
Diffuse Axonal Injury (DAI)
The shearing (tearing) of the brain’s long connecting nerve fibers (axons) that happens when the brain is injured as it shifts and rotates inside the bony skull.
- Damage to white matter.
- Changes are microscopic.
- Can lead to disorders of consciousness (persistent vegetative state, coma)
- Difficult to see on CT scan or MRI
- Can occur without other visible damage.
Grade 1 DAI
Mildest form of DAI
- Microscopic changes in the white matter of the cerebral cortex, corpus callosum, brain stem, and cerebellum.
Grade 2 DAI
Moderate form of DAI
- Grossly evident focal lesions isolated to the corpus callosum.
Grade 3 DAI
Severe form of DAI
- Additional and severe focal lesions on the brainstem itself.
Limitation to Glasgow Coma Scaale
- Substance use.
- Administered drugs.
- Intubation
- Injury to eye
- Hemiplegia
- Language
Non-Injury Risk Factors that Can Influence TBI Outcomes:
- Pre-injury psychiatric status and conduct issues/incarceration.
- Age at injury.
- Level of education.
- Stable employment 6 months pre-injury.
- Marital perceived social support.
- Other non-neurological injuries sustained.
Why loss of consciousness in SAH?
Transient intracranial circulatory arrest.
- The percussive blood pressure impact of the hemorrhage increase ICP (intracranial pressure) and therefore reduces CPP (cerebral perfusion pressure).
Hemiplegia
Paralysis affecting one side of the body
- Face, arm, trunk, leg
Hemiparesis
Implies a lesser degree of weakness than hemiplegia.
Neglect
Failure to attend to, respond to, and/or report.
- Stimulation that is introduced contralateral to the lesion.
- Most often seen with non-dominant parietal associations are lesions.
- Affects contralesional side.
- Persistent neglect is a negative functional outcome predictor.
Agnosia
Acquired inability to associate a perceived unimodal stimulus (i.e., visual, auditory, tactile) with meaning.
Disorder of Recognition
Not naming
Anosagnosia
Denial of deficit
Prosopagnosia
Impaired ability to recognize faces.
Tumors
Mass of cells whose growth is uncontrolled and that serves no useful function.
Malignant vs. Benign
- Benign more common in women; malignant more common in men.
- Depends on whether the tumor is encapsulated.
- Malignant can compress and infiltrate.
- Benign tend to only compress.
Primary Brain Tumor
Start in CNS
- Most commonly seen in those under 15 and above 65 years old.
Secondary Brain Tumor
Metastasize to brain.
- Most common brain metastases are from lung and breast cancer.
Grade 1 Tumor
Low proliferative potential
Possibility of cure after surgical resection
Grade 4 Tumor
Historical evidence of malignancy
Mitotically active
Prone to necrosis
Associated with rapid preoperative and postoperative disease progression and fatal outcomes.
Gliomas
Most common primary brain tumor type (33%)
- Tumor of the glial cells (astrocytes, oligodendrocytes, etc.)
Astrocytoma
Tumor of the astrocytes.
- Can be low grade of high grade.
- Grade 4 astrocytoma = glioblastoma multiforme.
* most aggressive tumor form
Meningioma
Tumor of the meninges, usually benign and slow growing.
- Encapsulated.
Main Tumor Treatments
Surgical Resection:
- Partial resection: “debulking”
- Total gross resection
Radiation:
- Whole brain
- Hippocampus sparing
Chemotherapy:
- Must cross blood-brain barrier
- Chemo-therapy impregnated wafer (gliadel wafers)
Seizure
Period of sudden, excessive activity of cerebral neurons.
- Epilepsy chronic diagnosis of recurrent seizures.
- Can be partial/focal or generalized.
Simple Partial-Seizure
No major change in consciousness.
Complex Partial-Seizure
Cause of loss of consciousness.
General Type Seizure
- Tonic-Clonic (aka Grand mal)
- Absence (aka petit-mal)
- Atonic
Tonic-Clonic Grand Mal Seizure
- Most severe form of seizure.
- Include convulsions (violence uncontrollable muscle movement).
Tonic Phase = stiffening of muscles.
Clonic Phase = jerking or twitching.
Absence “Petit Mal” Seizure
Sudden lapse in consciousness:
- Staring blankly into space.
- Eyelid fluttering.
- Lip smacking.
- Involuntary hand movement.
Lasts less than 15 minutes.
Atopic Seizures
“Drop Seizure”
- Sudden loss of muscle control = collapse or fall.
- Different to cataplexy in narcolepsy due loss of consciousness.
Challenges with Seizures
- 50% of those with seizures d/o show damage to the hippocampus.
- Falling
- Drowning
- Car accidents–unable to drive for 1 year post-seizure event.
- Pregnancy complications.
Emotional Health Issues with Epilepsy
- Most common = ADHD, anxiety, aggression.
- 6-10% experience post-ictal psychosis.
- Epilepsy increases risk of schizophrenia by 2.5x
Prion Diseases
Occur when prion protein, found throughout the body, begins folding into an abnormal three-dimensional shape.
- Damage prion protein destroys brain cells, leading to a rapid decline in thinking and reasoning (AKA Transmissible Spongiform Encephalopathies)
Creutzfeldt-Jakob Disease
MOST COMMON
- “Mad Cow Disease” epidemic of the 1980s to 1990s.
* People ate cows whose feed was contaminated with meat from ill sheep.
- Can be sporadic of familial.
- Causes severe mental deterioration and dementia–8 month.
Kuru Disease
From eating contaminated human brain tissue. Traditional practice of Fore people of Papa New Guinea:
- Cannibalism of decreased loved ones.
- 10-50 years incubation period.
- Kuru = “trembling” aka “laughing sickness”–leading to total loss muscle control and dysphagia.
Parkinson’s Disease
Cause by the degeneration of dopamine-secreting neurons in the substantia nigra that send axon to the basal ganglia –> a deficiency of autonmic, habitual motor responses.
- 95% of cases are sporadic.
Parkinson’s Disease Symptoms
Dystonia = Rigidity -> cognitive wheel test (lack of smoothness).
- Bradyskinesia and slow reaction times = falls.
- Shuffling gait.
- Face Masking
- Tremors:
* Pill Rolling Tremor: 75% (looks like they are rolling a pill in their hands).
Treatment for Parkinson’s Disease
- L-Dopa-time-limited, side effect of hallucination and delusions.
- Deprenyl - slows Parkinson’s progression.
- Intentional lesioning of the pathways.
- Deep Brain Stimulation:
- 75% relief of symptoms.
- Contraindicated in those with cognitive or memory improvement
Huntington’s Disease
Inherited disease resulting in degeneration of the basal ganglia.
- Chromosome 4 mutation = defects causes the building block of DNA called cytosine, adenine, and guanine (CAG) to repeat many more times than they normally do.
- <27 = normal
- 27 to 35 = can pass on but no symptoms
- 36+ = HD
- Typical onset 30 and 50.
- 10-15 year prognosis following symptom onset.
Huntington’s Disease Results In…
- Chorea-involuntary jerking movement.
- Dystonia.
- Slurred speech and swallow difficulties.
Amyotrophic Lateral Sclerosis
Degenerative disorder that attacks spinal cord and cranial nerve motor neurons -> brain and muscle connection loss.
- Average onset late 50s.
- 90%; 10% inherited.
- In inherited forms-mutation on chromosome 21.
Symptoms of Amyotrophic Lateral Sclerosis
- Progressive weakness and muscular atrophy-eventual loss of speech, swallowing with paralysis.
- Eye movement.
-Death typically caused by respiratory failure-typically within 24 months. - Only current pharmacological treatment in Riluzole (extends life by approx. 2 months)
Early Stages ALS
- Muscle weakness.
- Muscle twitching (fasciculation)
- Muscle Cramping
- Fatigue
- Poor balance
- Slurred speech
Middle Stages of ALS
- More severe muscle weakness
- Paralysis in some muscles
- Difficulty in swallowing
- Difficult in eating/chewing
- Breathing issues
- Bouts of uncontrollable laughter or crying (pseudobulbar affect).
Late Stage of ALS
- Paralysis in most muscles
- Extremely limited mobility
- Inability to speak
- Inability to breath without assistance
- Inability to eat without assistance
- Inability to drink without assistance
Multiple Sclerosis
An autoimmune demyelinating disease.
- At scattered locations within the CNS, the person’s immune system attacks myelin sheaths, leaving behind hard patches of debris called sclerotic plaques.
- Onset late 20s to 30s
- Damage occurs in white matter.
Risk Factors for Multiple Sclerosis
- Females > Males
- Living far from the equator.
- Black or white race.
- Smoking
Symptoms of Multiple Sclerosis
- Fatigue
- Vision problems
- Bladder/bowel dysfunction
- Spasms
- Slowed Processing Speeds
Types of Multiple Sclerosis
- Release Remitting
- Secondary Progressive
- Primary Progressive
- Progressive Relapsing
Meningitis
Inflammation of the meninges cause by viruses or bacteria.
What causes meningitis?
- Virus
- Bacteria
- Fungus
- Parasite
Symptoms of Meningitis
- Stiff neck
- Headache
- AMS
- Fever
- Photophobia
- Sometimes-convulsions, LOC, death
Etiology of Meningitis
- Spread of middle-ear infection to the brain.
- Head injury.
- Embolus that has dislodged from bacteria infection in the heart.
–> IV drug use dirty needles = increased risk.
Brudzinski’s Sign
Flexion of the hip and knees in response to neck flexion.
Kernig’s Sign
Resistance to extension of leg while the hip is flexed.
Dementia
Umbrella term for loss of memory and other thinking abilities severe enough to interfere with daily life.
Alzheimer’s Disease
60-80%
-Impairments in: episodic memory, language, cuing/recognition does not help.
- Neuritic plaques (B Amyloid) and neurofibrillary tangles (tau).
- Treatment with anti-inflammatory drugs results in low risk.
- Exposure to toxins, TBI, infection may trigger abnormal B amyloid formation (estrogen lowers your risk of developing Alzheimer’s).
- APOE gene is involved in making a protein that helps carry cholesterol and other types of fat in the bloodstream.
Vaccine research:
- Sensitize immune system against B Amyloid
Vascular Dementia
Associated with brain damage to:
- Ischemic injury.
- Anoxia.
Risk factors same as stroke risk factors.
Impairments in:
- Semantic memory.
- Visuospatial/perceptual skills.
- Slowed processing speed.
- With cuing/recognition paradigm can recall information.
Dementia with Lewy Body Disease
Characterized by the abnormal build-up of alpha-synuclein proteins into masses i.e., lewy bodies.
- Effects the chemical in the brain = symptoms
Symptoms of Lew Body Disease
- Visual hallucinations: 80% of the individuals early on in condition.
- Falls and dysautonomia.
- Movement issues.
- Sleep problems (i.e., REM sleep disorder common)
- Fluctuation cognition.
- Mood and behavior changes.
Fronto-Temporal Dementia
Umbrella term for a group of brain diseases known as frontotemporal lobar degeneration.
- Accumulation of Tau protein -> overwhelm the brain and causes tissue death.
3 Types of Fronto-Temporal Dementia
- Behavioral Variant: most common, changes in personality.
- Lacks empathy
- Increasing inappropriate social behavior.
- Changes in eating behaviors, desire to eat inedible foods. - Primary Progressive Aphasia: communication progressively worsens.
- Movement Disorders
Schizophrenia Risk and Development
- 46% concordance rate.
- 10x risk of African and Caribbean migrants.
- Men > Women
- Mutation in 21 and 23 chromosomes.
- Older paternal age.
- Atypical prenatal development (influenza, prematurity, preclampsia, gestational diabetes).
- Poor social adjustment and academic performance.
- Deficient psychomotor functioning.
Minor Physical Abnormalities with Schizophrenia
- High steepled palate.
- Partial webbing of two middle toes.
- Especially wide of narrow-set eyes.
Disease Burden with Schizophrenia
- 20% reduction in life expectancy.
- 40% of deaths are attributable to suicide.
Akathisia
Subjective unpleasant feeling of restlessness
Bradyskinesia
Slowness of movement
Tardive Dyskinesia
Symptoms irreversible but vitamin E can prevent further deterioration.
Extrapyramidal
Impairment in motor functions not related to the pyramids.
Anti-Cholinergic
Dry mouth, urinary retention, blurred vision, consitpation.
Depression
Heritability-families of person with affective disorders are 10x more likely to develop MDD or BMD.
Hedonic Tone/Responsiveness (depression)
Trait or genetic predisposition underlying one’s baseline range and lifelong ability to feel pleasure.
- Dysfunction of mesolimbic and mesocortical pathways.
- Loss of 40-90% of glial cells.
LOW Hedonic Tone: increase risk of anhedonia, depression, and dysthymia.
- Seen in MDD and ADHD
- SSRI emotional blunting-SNRIs better?
What explains the 3-6 week lag in treatment response time with depression?
Hippocampal neurogenesis
Generalized Anxiety Disorder
- Reduced connections between amygdala and PFC
- Activation of the vmPFC does not result in reduction of amygdala activation.
- Lowered GABA presence in amygdala.
Social Anxiety
Disproportionate activation of amygdala when viewing negative expression and neutral ones.
During a panic attack
- Increase activation of amygdala and periaqueductal grey.
- Can be induced by the breathing of CO2 and injection of lactic acid.
Anxious Apprehension vs. Anxious Arousal
Anxious Apprehension: increase activation in left frontal lobe (i.e., Broca’s)
Anxious Arousal: increase activation in right temporal lobe (i.e., increased sensitivity to environmental sounds and noises)
